Tuesday, April 14, 2009

Rage Survey

I am taking a survey on various methods of dealing with rage. At this point I'd like ideas other than holding. I've been going over a blog on holding and I will talk just about that tomorrow. It is important enough to take up about 5 blog posts, I think. Anyway, what are some methods you have of dealing with rages? It is such a serious problem but common with RAD. Here is a suggestion sent in by mom:

"It was amazing when I would get on with my life, how, fast the rages stopped. He was made to pay me, and the entire family's time back for every second his rage took away from peace in the family. We did everything from early bedtime to start (which we all needed anyway) to respite with a fun family outing at the end.

At the end I would drop him and whisper understandingly, empathetically, of his birth mom and it got real deep and personal. He HATED it. I would whisper things into his ear that would truly make him scream. Things about his abandonment that he was holding back, of orphanage life, etc... Enough said? He found other ways to get out his anxiety...I made him not want to rage."

I would like to say that any words we say while they are raging need to be sincere, calm and loving. We should not be sarcastic, yell nor be cruel. Or intent needs to love, make them feel safe and give them what they need. If you have any information about holding of any sort please email me at radmoms@hotmail.com and I may include it tomorrow. Otherwise you can just wait and post tomorrow. I can't wait to hear your ideas.

12 comments:

We once had a boy in the RTC where we worked that would rage for hours. Thankfully he was very easy to read, so if we caught the signs and could come up with something to make him laugh, the rage would be avoided. Then we would talk about what was really making him angry, but only after he was laughing and joking.

Restraining is sometimes very necessary, but there are ways to deal with rages before they get to that point. There has to be, right?

My M has gotten to the point where his rages are not true rages, but rather attempts at attention. So we ask him to go to his room. He would follow me around and collapse and yell, so now he must finish his tantrum in his room and he can come out and join the family when he is finished. The other children will either retreat to a part of the house away from his room, or go outside or turn up the volume on the TV. (which is the fastest, because it makes him crazy to hear TV but not see it!)

We send our rager to her room to make as much noise as she wants, she can come out as soon as she is calm. Totally erases any attention seeking part of it and rages went from days at a time, to one major one every week or two. I would still love to stomp them out entirely.Also, perscribing the problem works like a charm. I tell her to get it on-- here is your chance-- let it all out- louder! come on lets hear it! ________ nothing but a glare.

Like Essie, we prescribed the problem, always nice and encouraging though. We also would walk away and do something nice for ourselves, like watch the news, listen to music, or whatever. Something that signaled that she was not affecting our lives by raging. Even though I deal with little fits and screaming at us, I would say that we haven't had a full blown rage in at least a year. She could go for HOURS without seeming to take a breath, filled with so much anger and destruction. But no matter what we maintained that we loved her despite her anger shows and we would point out that she was only hurting herself by missing out on enjoyable things. It was difficult to not engage with her, but I do think that was key...to separate ourselves from her anger. It all sounds simple, but it was really hard, REALLY hard to not get sucked in. Hope this makes sense.

The only time I touched her was if she was physically attacking me and that was simply to defend myself. My husband did pick her up and put her outside (if the weather allowed) if she was destroying things. That was all. We always watched her, but tried to do so inconspicuously. When she would hurt herself, we did not feed into it, just took care of her afterwards and told her we were sorry for what she did to herself and had her apologize to herself and tell herself that she loves herself.

Oh, and the touching was totally defense, I know I said that, but I feel I need to clarify. I would just defensively put my arms up to prevent her from hitting me or kicking me or biting me or spitting on me.

It all sounds lame, but it worked for her. I did the same thing with my son and his mini rages of 45 minutes or so (more like big whopping tantrums) dissipated quickly. Haven't seen em at all in months.

I think Hanah's comment gets at the heart of the matter; to effectively deal with rages, it is imperative that you be able to read your child. The more time you spend together, just the two of you, the better you will get at reading the subtle cues and clues to your child's moods and the more effective you can be. The best way to deal with rages is to intervene BEFORE the rage.

When you have an out of control child (a dysregulated child) the child needs you to regulate the child level of arousal and the child's emotions because the child cannot do it for him/herself...just as with an infant; we regulate the infant's emotions and level of arousal. So, keeping the child with you and near is often most helpful (See Time in Parenting Strategies by Otto Weininger, for example).

As another parent pointed on, you must stay calm, authentic in your love and concern. If you can see the hurt and scared child inside the rage, you will do better at not becoming angry, upset and will exude empathy and understanding, which is at the core of helping a child in a rage. (The ATTACh parent manual has lots of specific ideas and suggestions based on these principles).

I hope this helps with your survey.Always a pleasure to post here...such great parents on a great blog.

We do primarily holding if the child is hurting themselves or someone else, but we try to avoid it whenever possible.

We try to keep the child calm and regulated (by staying calm and regulated too). Talking in a soothing, loving tone and reminding her that her perception of the situation is often off if it involves her triggers or issues (for example if Hubby says anything to her she accuses him of yelling at and criticizing her).

If she is functioning cognitively (not in fight, flight or freeze mode) then we threaten to put her in the FAIR Club (our version of discipline which she hates with a passion) or remind her that she will most likely lose some privilege (eating out, watching a movie or show...).

I have stood back and calmly supervised whenever possible (most of the time she threatens but doesn't follow through). I worry that she's escalating her behaviors to try to get us to react though.

Mostly we just stand about 5 feet from her. Not engaging, but letting her know that we are there for her and will keep her safe.

If she's threatening to run away we will take away all her shoes (makes her crazy) and put her on a "4 foot rule" has to be no more than 4 foot away from mom or dad.

Brenda, I thought it was funny that today our therapist talked specifically about how some kids become addicted to restraint. I thought of you!

We have kept Mar from escalating to that point for the last three days. She tried today, during therapy (and after, of course), but we stayed right on top of it. No rage. No need to restrain. But boy howdy, was that her goal.

Right now with all that is going on in her life, she desperately wants to get to that point. It will be a very tough job for awhile.

BEFORE, these recent weeks, however, just giving everyone in the house an extra privilege or treat REALLY curbed the rages. If it was just mainly me that suffered, then I would go out to eat sometime that week (on their allowance money). For my 12-yr-old, it was worse than DEATH! :)

So true how you have to know your kid, and you also have to be very aware of where they are at any particular time. My kids have raged plenty as a way to get attention and take away time from the rest of the family. Yet, they have also raged out of fear. Mar is purposefully looking for ways to rage right now to stop the adoption from happening - terrified we will begin beating her once it is "legal." She needs to either stop it altogether or do her best to pull out our "real" personalities and get the "truth" out there. So, we do everything in our power to keep her regulated.

Sometimes that starts before she even leaves her bedroom. I have been on "Silliness Alert."

FYI: I have been known to break a child out of a rage by shaking my butt while singing "Baby Got Back." They just absolutely cannot focus on a rage when their mother is over in the corner shaking her groove thing and belting, "I like big butts and I cannot lie ..."

I use video taping and give words to the feelings: "you look so angry. are you mad that you can not... you are screaming, kicking and flailing around pretty good there, does that help you to feel better? when you are done, can we talk instead?" I also give time-limits, "you may tantrum for 2 more minutes. If you use more of my time than I will take some of your time later." I make sure to talk about other ways to handle that anger during a "happy" time. I only use holding if injury is caused to self or others.

We have a 2 step process now ( after a long journey of trying lots of things) our rager is sent sent to sit on the stairs first and given a chance to calm down with an adult standing in his sight ( he is afraid of being alone) but not close enough to touch. If he can't calm down himself he is calmly escorted outside, he stays outside alone with an adult on the other side of the glass door, when he is calm and ready to move on he comes back in - there is always some cuddling and talking about how we love him but that the behaviour (raging at us) is not okay.

If we see a rage coming on we call him on and try to redirect to something. Calvin I see that you are really mad, I think that you are going to lose control in a minute, why don't we go and _____ instead. Sometimes is works, sometimes not.

We rarely restrain him - only if he is hurting himself or one of us and if we do it does not last very long at all, less then 3 minutes. If he is being retrained we are telling him the whole time that we will be able to release him when he can calmly talk to us about not hurting people, including himself.

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Symptoms of Reactive Attachment Disorder (as listed by Mayo Clinic)

"Reactive attachment disorder is broken into two types — inhibited and disinhibited. While some children have signs and symptoms of just one type, many children have both.

Inhibited type:In inhibited reactive attachment disorder, children shun relationships and attachments to virtually everyone. This may happen when a baby never has the chance to develop an attachment to any caregiver.Signs and symptoms of the inhibited type may include:Resisting affection from parents or caregiversAvoiding eye contactAppearing to seek contact but then turning awayDifficulty being comfortedPreferring to play aloneAvoiding physical contactFailing to initiate contact with othersAppearing to be on guard or waryEngaging in self-soothing behavior

Disinhibited type:In disinhibited reactive attachment disorder, children form inappropriate and shallow attachments to virtually everyone, including strangers. This may happen when a baby has multiple caregivers or frequent changes in caregivers.Signs and symptoms of the disinhibited type may include:Readily going to strangers, rather than showing stranger anxietySeeking comfort from strangersExaggerating needs for help doing tasksInappropriately childish behaviorAppearing anxiousA word of caution: Not all experts agree on the signs and symptoms of reactive attachment disorder. Some attachment therapists use checklists with numerous nonspecific signs and symptoms that go well beyond what the American Psychiatric Association includes in its definition of the disorder. Be cautious when trying to interpret checklists that include such symptoms as lack of eye contact, rage, aggression, lying, stealing, hoarding food, an apparent lack of a conscience, nonstop chatter, and a desire to wield control. These nonspecific symptoms are difficult to apply to any one diagnosis."

My own two children present their cases of RAD very differently from one another. A professional diagnosis is necessary as other disorders share some of the symptoms. If you are frustrated because your child has worked with a variety of therapists and a variety of treatments with no change maybe you should have him/her checked for RAD with an experienced Attachment Therapist. There is help. You are not alone.

Disclaimer:

Reactive Attachment Disorder (RAD) is a profound disturbance. If you suspect your child may have RAD please seek the professional counsel of an attachment therapist. Above you will find links that will hopefully help you find an attachment therapist. This blog is just my thoughts and ideas as an adoptive mom. I do not know your child and cannot be responsible for results from trying any ideas you find on this blog.

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About Me

I am a children's therapist from Nebraska. My husband and I have raised 5 children. Two were diagnosed with RAD. They struggle in many ways, but have grown to be productive members of society and living on their own. There is hope for your child.